This Is How We Can Use The Internet To Improve Health

The world wide web is filled with health advice. Unfortunately, recommendations may not be all that reliable. That's why many public health professionals look down on this type of consultation.

That being said, this trend has risen over the years and shows no signs of slowing. This means authorities and officials need to realize they must follow the old adage, "If you can't beat 'em, join 'em." Yet, the means to perform this effectively has been rather enigmatic.

One direction followed by many trusted health sources provides key information in an objective, one-size-fits-all manner. This populist method focuses on sharing evidence and advice applicable to the masses. Yet, this method may inadvertently lead to the concept of health brokering in which one person ends up being the trusted source for advice. While this may not be entirely troublesome, the entitlement may be given to a person with extensive online acumen but limited health knowledge.

This conundrum reveals a significant hurdle in providing appropriate advice using the internet. While information may be readily available, the need for a personalized touch is left unfulfilled. Yet finding a suitable health broker for every single person visiting a website is simply not possible. A middle ground needs to be found whereby information is both useful and to some extent personal.

That balance may have been found thanks to a large-scale initiative known as the Food4Me study. Conducted by an international group of researchers, this attempt to determine how best to personalize medicine has revealed what the public needs in addition to information to make healthy decisions. As the study has found, the requirements are far less than what one might expect.

The study was an attempt to mimic an online personal nutrition service. The actual nutritional information based on evidence was the same for everyone. Yet, how it was used to coach individuals varied based on one of four levels of personalization.

Those in Level 0 received general information geared for the European population;

Level 1 individuals gained advice based solely on dietary intake;

Level 2 included body measurements and blood tests;

Level 3 also involved genetic analysis of the individual.

The first level was essentially the Dr. Google control. Level 1 was the type of personalization expected from an online service. Levels 2 and 3 were far more extensive in nature as they required the individual to visit the home base to allow for the measurements and blood analysis.

The study ran for six months with over 1,200 people equally divided among the four levels. As the study began, participants in Levels 1-3 received personalized feedback reports developed by dietitians. The information was based on the collection of data they received.

At the half way point and also at the end of the study, the participants were asked to fill out a questionnaire regarding their dietary intake. Based on replies, messages were sent out to remind the individuals of any gaps in their recommended diets. To emphasize the personal nature of the coaching, the advisories also referred to specific data acquired at the onset of the study.

After the study was completed, the team examined the questionnaires and other information collected from the participants in order to determine if any changes had been made in their dietary habits. In all cases, the answer was yes although those in the Level 0 control appeared to make the least amount of change. This came as no surprise as the objective method was expected to have the poorest results.

The real surprise came when the team examined the other levels. Based on the amount of information collected, a difference between the levels would have been expected with Level 3 showing the highest amount of change. Yet, there were no such gaps. The information collected appeared to have no value in terms of the actions of the individuals.

The lack of a link between more information and improved results was revealing. The impetus for change was not based on the amount of personalized data collected. Instead, the force behind change happened to be something far less scientific: personalized motivation. By having someone there to guide you -- even irregularly as in this study -- people may be given the encouragement necessary to make beneficial changes in their lives.

This study offers good insight into how health advice may be best provided on the internet. Having readily available information is a key component. But having a personal touch may lead to increased trust and eventually acceptance and adoption of the recommendations.

For doctors, dietitians, and other qualified professionals, this study may open the door to improving health through online consultation. Keeping track of and giving feedback to patients virtually may effectively improve behaviour and outcomes. Moreover, this could help to solidify the relationship between an individual and the health profession such that one day a person may consult a known and trusted professional instead of relying on a broker or whatever comes up during a web search.

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Doctors Answer Your 9 Biggest Health Questions

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Many women start to feel like they're dragging in their late 30s and 40s. They're losing testosterone, which may act as an antidepressant, and experiencing a flux in their levels of estrogen and progesterone, which may also influence mood and energy. One of the most effective tactics for perking up comes down to how you plan your meals. "Many of my clients seem to think that by filling one meal with energy-generating nutrients -- say, a green smoothie for breakfast or a salad at lunch -- they've done their duty for the day," says dietitian Ashley Koff. "But your body needs several energy pit stops so you can refuel." Koff suggests small meals every three hours that combine a variety of nutrients. Her energy-boosting meal plan:
Breakfast: Oatmeal with hempseeds.
A.M. snack: Half cup of cottage cheese with berries.
Lunch: Half a turkey sandwich with salad.
P.M. snack: Half cup of tuna salad with wheat crackers.
Dinner: Wild salmon with nonstarchy veggies.

Two free surefire solutions: diet and exercise. Losing even a few pounds can provide tremendous relief. One study found that for every pound you drop, you take four pounds of pressure off your knees. "Low-impact exercises -- walking, swimming, cycling -- help maintain a healthy weight and muscle mass as well as release endorphins, all of which can lead to a decrease in pain," says Roxanne Wallace, MD, an orthopedic surgeon at Marshfield Clinic in Wisconsin.

Down, girl. As long as you have no open wounds, you can welcome Sparky's affection. "A healthy immune system is strong enough to fight off most bacteria in a pet's saliva," says Jennifer Gabriele, a vet at Heart of Chelsea Animal Hospital in New York City.

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Sorry, cupcake, it doesn't look good. Too much of the sweet stuff can wreak havoc on your entire body. Added sugars have been associated with inflammation, a condition linked to obesity, type 2 diabetes, and heart disease. In fact, a 2014 study found that people who consumed 17 to 21 percent of their daily calories from added sugar had a 38 percent higher risk of dying from heart disease than those who got only 8 percent. For most women, the American Heart Association recommends no more than 100 calories from added sugar daily.

You can ignore the old eight-glasses rule: Six is typically plenty to hydrate you and keep everything in working order, according to a review in the European Journal of Clinical Nutrition.

You may have small intestine bacterial overgrowth (SIBO), a condition common among those suffering from chronic bloating. SIBO can occur when bacteria in the colon migrate up into the small intestine and ferment the carbs passing through, creating gas. Consider switching to a diet low in fermentable foods (which include dairy, wheat, and high-fructose fruits) so the bacteria will have less to feast on, says Johns Hopkins gastroenterologist Gerard E. Mullin, MD, author of The Gut Balance Revolution. Research has shown that the plan works: A study in the journal Gastroenterology found that the majority of subjects with irritable bowel syndrome reported significantly less bloating when they followed a diet low in bacteria-loving foods.

"If you misrepresent the facts, you limit what your doctor can do for you," says Lissa Hirsch, MD, an obstetrician and gynecologist at Lenox Hill Hospital in New York City. Some of your lies will be revealed by your blood work or the number on the scale, but otherwise your doctor has nothing to go on but what you report -- and that could be dangerous. Say you fib and tell her you're following a diet and exercise program to lower your blood sugar. When your "plan" doesn't seem to be working, she may prescribe medication you don't need, unwittingly putting you at risk for unnecessary side effects. In other words, when your pants are on fire, you'll be the one who gets burned.

Depends on what you're eating, says health reporter Catherine Price, who spent three years putting that question to more than a dozen top doctors and researchers for her recent book, Vitamania: Our Obsessive Quest for Nutritional Perfection. "If you're eating a good amount of foods naturally rich in vitamins, like produce, and those that are fortified, like cereal or bread, a multivitamin is probably superfluous," she says.* But if you do decide to take one, keep in mind that the FDA doesn't test dietary supplements to ensure that what's on the label is actually what's in the bottle. Check for a seal that says NSF or USP VERIFIED -- both are respected third-party companies that vitamin-makers can pay to review their products.
*A multivitamin containing folic acid is always a good idea for women during their reproductive years.

Of course no one has a magic formula, but Marie Bernard, MD, deputy director of the National Institute on Aging, has a few ideas:
See your doctor regularly. "At the turn of the 20th century, the average American life-span was about 45 to 50 years," says Bernard. "Today people live well into their 70s and beyond, and many experts believe that increase is due in part to preventive health measures."
Maintain friendships. A new Brigham Young University review revealed that social isolation increases your risk of mortality by up to 32 percent -- on par with obesity.
Learn a new skill. A recent University of Texas at Dallas study found that people who mastered a new and challenging skill (like digital photography or quilting) showed greater gains in memory than those who performed passive activities, like crossword puzzles. So get out there and start learning!